In Practice

The National Health Insurance, the decentralised clinical training platform, and specialist outreach

R I Caldwell, C Aldous

Abstract

According to the Constitution of South Africa (SA), citizens living in remote areas are entitled to the same level of healthcare as those with access to tertiary hospitals. Specialist outreach has been shown to achieve this. When SA’s National Health Services Commission convened (1942 - 1944), Gluckman summarised: ‘Where the need is greatest the supply of hospitals is least.’ Primary healthcare (PHC) characterised the Kark’s Pholela Health Centre and was highly regarded. Although PHC underpins National Health Insurance (NHI) planning, both preventive and curative healthcare are needed. The KwaZulu-Natal (KZN) provincial Department of Health and the University of KZN College of Health Sciences’ 5-year plan for a decentralised clinical teaching platform (DCTP) is ambitious, requiring optimum co-operation between health department and university. Reservations can be addressed through sustained specialist outreach. Above all, the patient mustbe the chief beneficiary. The NHI and DCTP overlap with specialist outreach, but cannot do without it.

Authors' affiliations

R I Caldwell, School of Clinical Medicine, Department of Internal Medicine, College of Health Sciences, University of KwaZulu-Natal, Pietermaritzburg,
South Africa

C Aldous, School of Clinical Medicine, Department of Internal Medicine, College of Health Sciences, University of KwaZulu-Natal, Pietermaritzburg,
South Africa